A group of four foundations has partnered to establish a $10 million fund that will be used to expand the OpenNotes program from its current state as an experimental patient engagement strategy to an established national program with the potential of reaching 50 million patients. Cambia Health Foundation, Gordon and Betty Moore Foundation, Peterson Center on Healthcare, and the Robert Wood Johnson Foundation will fund the initiative. OpenNotes is the concept of providing patients with full, transparent access to their medical records including all provider notes. The investment is designed to fund expansion efforts for the next three years. OpenNotes will use the funding to help new providers implement OpenNotes and to measure the impact that OpenNotes has on health outcomes and cost containment.

OpenNotes began as an experiment at Beth Israel Deaconess Medical Center in 2010. A Robert Wood Johnson Foundation funded study was conducted in which 105 primary care providers expanded their patient portals to provide complete access to patient notes for one year. During that time, 13,564 patients had at least one note entered into the system by one of the providers. 84 percent of the patient population included in the study logged into the patient portal and read their providers note. Nationally, patient portal utilization rates tend to be much lower than that, hovering in the 20 to 30 percent range, with subtle variations for patient age and provider group size. The patients that did access their records were asked to complete a survey at the end of the study. 87 percent of those that responded indicated that reading their provider’s notes helped them feel more in control of their care, while 60 to 78 percent reported an increase in medication adherence. Only one to eight percent of respondents reported that the notes caused confusion, worry, or offense.

Digital health startups attracted $4.3 billion in new investments during 2015, according to a recently published Rock Health report on funding activity in the digital health market. The investment total matches but does not top 2014’s record-setting levels, indicating that while funding opportunities are still strong in digital health, year-over-year investment growth has plateaued for the first time since Rock Health began tracking digital health investment activity. Overall, digital health accounted for seven percent of 2015’s total venture capital investment activity.

This year brought 278 total investment rounds, fewer than in 2014, but as the market and its startups continue to mature there have been a larger number of late-stage, high-value investments which is drove up the average deal size and kept 2015’s funding levels on pace with 2014. The average funding round was worth $15.6 million this year, up from 2014’s $14.7 million. While seed and Series A rounds continue to account for more than 50 percent of all deals, late stage Series C and D rounds are now accounting for 25 percent of total investments, up from 2014. Another metric to measure the maturing digital health market is startup size. Average head count at digital health startups has climbed from 39 in 2013 to 44 in 2014 and now to over 50.

In March 2015, Google and Johnson & Johnson announced a strategic partnership focused on co-developing next generation surgical robots that will use augmented reality and image recognition software to help surgeons navigate the body and to provide on-screen clinical decision support alerts during the procedure.

For surgeons performing robot-assisted procedures, the announcement is likely welcomed news. In recent years, the medical community has been casting an increasingly skeptical eye toward surgical robots. The machines are prohibitively expensive and have failed to reduce complications or improve outcomes at the rates anticipated when they were first introduced to healthcare. In 2010, the New England Journal of Medicine published a study comparing the cost and outcomes of robotically-assisted procedures and traditionally performed procedures, concluding that the outcomes were comparable and did not justify the increased cost. Following that study, the FDA issued a statement questioning the overall value of surgical robots, and the American Congress of Obstetricians and Gynecologists issued an updated policy letter stating that robotic-assisted hysterectomies were unwarranted due to their cost and negligible impact on outcomes. Thus far, surgical robots have failed to improve outcomes at levels that justify their use; instead they introduced another high-tech, high-cost alternative to traditional surgical procedures.

Medtronic announces that it has expanded its partnership with Samsung to develop more mobile health tools for the chronically ill. Announced at this year’s North American Neuromodulation Society Scientific Session in Las Vegas, the new partnership will focus on developing tools for patients that rely on neuromodulation therapy to treat a wide variety of conditions, including chronic pain, tremors, incontinence, and movement disorders.

Neuromodulation is a medical treatment that involves altering problematic nerve activity with either an implanted device that delivers a small eclectic current, an implanted drug delivery system, or a non-invasive method that relies on magnetic stimulation of the brain. For most patients, neuromodulation involves having a transplant that connects electrodes or drugs directly to the spine or brain. Chronic pain is the most common condition that results in a patient receiving neuromodulation therapy, but Parkinson’s patients; epileptic patients; and patients with incontinence, migraines, spinal cord injuries, and a variety of ischemic conditions also benefit from the treatment.

Danish diabetes pharmaceutical company Novo Nordisk announces that it will work with IBM Watson Health to co-develop new online resources designed to personalize care plans for diabetic patients. The Wall Street Journal reports that the new solution will integrate with continuous glucose monitors to track blood sugar levels and make personalized insulin dosage recommendations. Novo Nordisk’s Executive Vice President Jakob Riis explains, “a lot of routine issues around judgments of dosing and the whole interplay between food intake, exercise, and insulin that could be better handled by AI that can draw on a much broader source of data.” Interestingly, Riis reports that unlike earlier Watson R&D partnerships, Novo Nordisk also plans to analyze the 50 million anonymized patient records contained within Watson to quantify the value that its medications bring to population health, information that it will use to negotiate better prices with payers. Lastly, Novo Nordisk will analyze records to learn more about what kinds of medications work best in certain populations. Financial terms of the deal were not disclosed.

For IBM, partnerships like these have become commonplace. IBM has signed a multitude of hospitals to work with it on precision medicine projects that all center around the idea of pushing new research findings into clinical practice faster. Fourteen cancer centers, including MD Anderson and other prestigious facilities, are working on Watson-related projects. In May, Epic partnered with IBM and Mayo Clinic to co-develop more precise clinical decision support alerts. In September, it signed a deal with Johnson & Johnson to help it develop an app designed to improve post-surgical recovery for total knee replacements. The company has partnered with dozens of businesses representing every institution type in healthcare, but between the deals, a trend is emerging.

Cambridge, MA-based population health startup GNS Healthcare announces that it has closed a $10 million Series C funding round. Existing investors Cambia Health Solutions, California’s Heritage Provider Network, and Japan’s Mitsui & Co. joined new investors Alexandria Real Estate Equities, Celgene Corp., and Gi Global Health Fund. The new round follows a $10 million Series B from January 2014 and an $8 million venture round from May 2015. Since its 2000 launch, GNS has raised $44 million, with the vast majority of those investments coming in the last five years.

GNS Healthcare is a data analytics firm at its core, leveraging machine-learning algorithms to risk stratify patient populations and recommend personalized intervention sets for each high-risk patient that have been shown to deliver a positive ROI in other, similar patients. The result of all this number crunching, it says, is a big data approach to population health that works. The team says that its algorithms will evaluate multiple possible interventions for a patient, and then create a multi-modal plan of attack that is most likely to achieve the desired outcome. It then calculates the forecasted cost of moving forward with the recommended interventions and compares that with the forecasted cost of care without additional interventions, resulting in an ROI calculation for each individual within the population.

San Diego-based chronic disease management startup MD Revolution announces that it has closed a $23 Million Series C co-led by Jump Capital and an anonymous “leading global healthcare technology company.” The funding follows a $9 million Series B round raised entirely from individual investors, and brings its total funding level to $33 million since its 2011 launch. The team at MD Revolution spent more than a year developing its business model within the incubator at EvoNexus, graduating in June 2014 and launching its flagship chronic disease management platform shortly thereafter.

MD Revolution’s business model takes advantage of recent changes to Medicare reimbursement policies that now allow providers to bill for 20 minute, monthly telehealth visits with patients managing chronic diseases. The visits are worth an average of $42 per patient, per month. The company’s platform, RevUp, has both provider-facing and patient-facing components that help facilitate these virtual visits. On the patient-facing side, the RevUp app facilitates nutritional and food journaling, and uses Qualcomm’s 2net platform to connect with other fitness apps, medical devices, and wearables. RevUp targets visceral fat, Vo2, and metabolism as its core health metrics. It then uses this information to calculate disease-specific RevUp weekly points, which it uses to help convey to patients where they stand as far as their weekly disease-management goals. MD Revolution backs this process up with a communications platform that connects patients with wellness coaches and a remote clinical team to help field simple questions and keep users engaged. On the provider side, RevUp integrates with core EHR systems to risk stratify the patient population and help providers target the most at-risk patients.

Momentum is gaining in the scientific pursuit of 3D-printed complex organs. While the field is still relatively young, a great deal of progress has been made in a short period of time. As it stands today, researchers have discovered through trial and error that in order to engineer a viable human organ, one must first create the complex structure of blood vessels that deliver nutrients to each cell within the organ. From here, various types of cells need to be carefully arranged around this vascular framework. “Single cell resolution,” a term specific to the 3D bio-printing movement, is required to accurately layer these cells around the vascular networks in a way that will keep each cell healthy and yield a viable, functional organ.